Safetynet populations are often more susceptible to COVID-19 due to poor housing conditions that are the legacy of years of structural racism within the housing system. 

Some of these practices of the past, supported at the time by the Federal Housing Administration (FHA), include:

• Subsidy of housing builders so long as none of their homes were sold to African Americans. 

• Denial of African American families federally backed insurance for their housing loans (Rothstein, 2017).

The result was segregated neighborhoods that were and continue to be riddled with inequity. For example, prominently African American neighborhoods are often characterized by:

• less economic investment 

• fewer resources, i.e. spaces for recreation

• high rates of pollution and noise

• overcrowding 

Many of these conditions are positively associated with asthma, obesity, and cardiovascular disease, all of which increase COVID-19 susceptibility (Mobley et all., 2006; Larson et. all, 2009). 

In addition to inequity within the greater community, houses themselves often possess health-related violations that are more prominent in the neighborhoods of racial and ethnic minorities. These include:

• code violations for asbestos, mold, and cockroaches 

• plumbing without hot and cold water

• no flushing toilet

• no bathtub or shower

• kitchen facilities without a sink with a faucet

• no stove or range oven 

• more than 1.5 persons per room 

Without plumbing, it is impossible to uphold CDC’s guidelines on thorough hand washing and body washing after going to work or out in public to obtain essential supplies (Scott, 2020; St. Louis Partnership for a Health Community, 2017).

Thus, Safetynet populations are often burdened with health conditions that are acquired over time as well as the inability to maintain health in the moment as a result of housing conditions. Their susceptibility increases as they are more vulnerable to catching the virus due to poor health and are rented properties without the amenities needed to maintain the hygiene necessary to reduce risk. 

Underlying Conditions

Due to their minimal healthcare access, Safetynet populations have an increased likelihood of being diagnosed with an underlying medical condition, making them more susceptible to COVID-19. 

Underlying health conditions, which are long-term illnesses or chronic diseases, weaken the immune system, therefore causing a higher susceptibility of these individuals to illness and death. In the world of COVID-19, the CDC and other reputable health departments have indicated that individuals with underlying health conditions are more likely to experience worse symptoms or complications from the disease. According to the CDC, individuals at higher risk are those with certain underlying medical conditions, including: 

• Severe obesity 

• Diabetes 

• Serious heart conditions 

• Chronic lung disease 

• Moderate to severe asthma 

• Liver disease 

• Immunocompromised  

In regard to Safetynet populations, individuals within these communities are at an increased risk of having or developing underlying conditions. To see detailed health data by county, the South Carolina Department of Health and Environmental Control (DHEC) has an interactive map called the South Carolina County Health Profile, which you can view here along with other county level data. Looking at this data, there is a correlation between counties with a higher percentage of individuals lacking health insurance or a higher percentage of families below the poverty level and underlying health conditions. This exemplifies that Safetynet populations may be at a higher risk for underlying medical conditions. Safetynet populations may have a larger chance of having underlying medical conditions because they may:  

• Lack health insurance, or have minimal coverage  

• Lack funds to cover healthcare expenses  

• Have minimal healthcare access 

• Have minimal access to health education services  

• Have poor nutrition and exercise habits 

• Lack a location to participate in physical activity 

• Lack exercise programs in schools  

• Eat out at restaurants, which results in larger food servings and sodium levels 

• Have poor mental health and outside stressors  

• Lack the funds to purchase foods lower in calories or sodium 

Thus, the increase of underlying health conditions in Safetynet populations represents a potential for Safetynet populations to have more severe symptoms as a result of Covid-19.